How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $562.34 Median $5,495.41 Typical High $14,125.38 | Facility | None | $562.34 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $1,258.93 | Professional | None | $537.03 | $562.34 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $645.65 | Professional | None | $426.58 | $512.86 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $616.60 | Professional | None | $446.68 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $870.96 | Professional | None | $426.58 | $630.96 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $602.56 | Professional | None | $407.38 | $489.78 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $870.96 | Facility | None | $537.03 | $676.08 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,148.15 Typical High $5,128.61 | Facility | None | $489.78 | $1,148.15 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $2,454.71 | Professional | None | $489.78 | $660.69 | $2,454.71 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,047.13 | Professional | None | $426.58 | $724.44 | $1,047.13 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $56.23 |
Where Virginia sits
The same service costs 3.9 times more in Wisconsin than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 45th of 51
$562
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.